The purpose of this two-year R-21 project is to develop and test an occupation-based intervention for fostering successful adaptation of elders who relocate to long-term care facilities (LTCF). The aims of this mixed methods study are: (1) to describe selected person factors of elders that contribute to adaptation to LTC settings, (2) to develop an occupation-based cultural heritage intervention based on the results of Aim 1, and (3) to test the effect of an occupation- based cultural heritage intervention on the adaptation of elders in LTCF. The hypothesis for Aim 3 is: LTC residents, 60 years of age and older, who participate in an occupation-based cultural heritage intervention will report significantly higher measures of adaptation as noted by activity engagement, social participation and quality of life compared to LTC residents who participate in a usual activity group. Twenty-four elders will be recruited and qualitative methods employed to achieve Aim 1. To accomplish Aim 3, 192 elders will be recruited and randomly assigned to receive intervention or control conditions. Quantitative analysis will compare measures of adaptation for those assigned to the cultural heritage intervention and those who receive a usual activity group. All elders, African-American and Caucasian, will have relocated within the past six months to a licensed nursing care unit in one of six LTC settings. The intervention will incorporate findings about valued aspects of residents' cultural backgrounds, as well as existing models of intervention based on cultural heritage. The intervention will be provided on a group basis to participating elders, who will be compared to control groups of elders matched on gender, age, and ethnicity. The intent of this project is to test an intervention strategy that incorporates diverse cultural values and beliefs that can be replicated in future large-scale multi- geographical studies. [unreadable] [unreadable] [unreadable]